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Pseudoaneurysm formation in infective endocarditis
Jeffrey J Silbiger1, Andrew Krasner, Joanna Chikwe
1Department of Cardiology, Icahn School of Medicine at Mount Sinai Services, New York.
Echocardiography (Mount Kisco, N.Y.)
|August 3, 2013
Summary
Left ventricular pseudoaneurysms, often from infective endocarditis, form sac-like protuberances due to abscess remodeling. These can lead to complex fistulas, impacting cardiac structures.
Area of Science:
- Cardiology
- Cardiac Surgery
- Infectious Diseases
Background:
- Left ventricular pseudoaneurysms (LVPs) are rare but serious complications.
- They are often associated with infective endocarditis and abscess formation.
- Understanding their pathogenesis is crucial for diagnosis and management.
Observation:
- LVPs result from remodeling of extravalvular abscesses.
- High left ventricular pressure dissects into the abscess, creating a pseudoaneurysm.
- Echocardiography is key for recognizing these sac-like protuberances.
Findings:
- Most LVPs originate from mitral-aortic intervalvular fibrosa abscesses, protruding externally.
- Less commonly, they arise from posterior mitral annulus abscesses, projecting into the interventricular groove.
- Perforation can lead to various fistula formations, including aorto-cameral and pericardial.
Implications:
- Accurate echocardiographic recognition is vital for timely intervention.
- Understanding anatomical origins aids surgical planning.
- Potential for complex fistulous communications necessitates comprehensive evaluation.
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